PMID- 34868978
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211207
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA 
      Plus Arsenic Era: A Population-Based Study.
PG  - 762653
LID - 10.3389/fonc.2021.762653 [doi]
LID - 762653
AB  - Most randomized trials for acute promyelocytic leukemia (APL) have investigated 
      highly selected patients under idealized conditions, and the findings need to be 
      validated in the real world. We conducted a population-based study of all APL 
      patients in Zhejiang Province, China, with a total population of 82 million 
      people, to assess the generalization of all-trans retinoic acid (ATRA) and 
      arsenic as front-line treatment. The outcomes of APL patients were also analyzed. 
      Between January 2015 and December 2019, 1,233 eligible patients were included in 
      the final analysis. The rate of ATRA and arsenic as front-line treatment 
      increased steadily from 66.2% in 2015 to 83.3% in 2019, with no difference among 
      the size of the center (>/=5 or <5 patients per year, p = 0.12) or age (>/=60 or <60 
      years, p = 0.35). The early death (ED) rate, defined as death within 30 days 
      after diagnosis, was 8.2%, and the 3-year overall survival (OS) was 87.9% in the 
      whole patient population. Age (>/=60 years) and white blood cell count (>10 x 
      10(9)/L) were independent risk factors for ED and OS in the multivariate 
      analysis. This population-based study showed that ATRA and arsenic as front-line 
      treatment are widely used under real-world conditions and yield a low ED rate and 
      a high survival rate, which mimic the results from clinical trials, thereby 
      supporting the wider application of APL guidelines in the future.
CI  - Copyright (c) 2021 Zhu, Ma, Yu, Ouyang, Luo, Pei, Xu, Hu, Mo, Xu, Lan, Shen, Shou, 
      Qian, Feng, Zhao, Jiang, Hu, Zhang, Qian, Wu, Wu, Qiu, Li, Lang, Chen, Chen, Guo, 
      Cao, Jiang, Xia, Le, Zhao, Huang, Zhang, Lv, Hua, Hong, Zheng, Wang, Hu, Chen, 
      Zhang, Tao, Xie, Kuang, Luo, Su, Guo, Wu, Jiang, Zhang, Zhang, Chen, Xu, Guo, Tu, 
      Hu, Yan, Yao, Lou, Jin and the APL Cooperative Group of Zhejiang Province.
FAU - Zhu, Hong-Hu
AU  - Zhu HH
AD  - Department of Hematology, The First Affiliated Hospital, College of Medicine, 
      Zhejiang University, Hangzhou, China.
AD  - Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, 
      China.
AD  - Zhejiang University Cancer Center, Hangzhou, China.
AD  - Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical 
      Center, Hangzhou, China.
FAU - Ma, Ya-Fang
AU  - Ma YF
AD  - Department of Hematology, The First Affiliated Hospital, College of Medicine, 
      Zhejiang University, Hangzhou, China.
FAU - Yu, Kang
AU  - Yu K
AD  - Department of Hematology, The First Affiliated Hospital of Wenzhou Medical 
      University, Hangzhou, China.
FAU - Ouyang, Gui-Fang
AU  - Ouyang GF
AD  - Department of Hematology, Ningbo First Hospital, Ningbo, China.
FAU - Luo, Wen-Da
AU  - Luo WD
AD  - Department of Hematology, Taizhou Hospital of Zhejiang Province affiliated to 
      Wenzhou Medical University, Taizhou, China.
FAU - Pei, Ren-Zhi
AU  - Pei RZ
AD  - Department of Hematology, The Affiliated People's Hospital of Ningbo University, 
      Ningbo, China.
FAU - Xu, Wei-Qun
AU  - Xu WQ
AD  - Department of Hematology, The Children's Hospital Zhejiang University School of 
      Medicine, Hangzhou, China.
FAU - Hu, Hui-Xian
AU  - Hu HX
AD  - Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School 
      of Medicine, Jinhua, China.
FAU - Mo, Shu-Ping
AU  - Mo SP
AD  - Department of Hematology, The Affiliated Hospital of Jiaxing University, Jiaxing, 
      China.
FAU - Xu, Xiao-Hua
AU  - Xu XH
AD  - Department of Hematology, The Second Affiliated Hospital Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Lan, Jian-Ping
AU  - Lan JP
AD  - Department of Hematology, Zhejiang Provincial People's Hospital, Hangzhou, China.
FAU - Shen, Jian-Ping
AU  - Shen JP
AD  - Department of Hematology, Zhejiang Provincial Hospital of Chinese Medicine, 
      Hangzhou, China.
FAU - Shou, Li-Hong
AU  - Shou LH
AD  - Department of Hematology, Huzhou Central Hospital, Huzhou, China.
FAU - Qian, Shen-Xian
AU  - Qian SX
AD  - Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang 
      University School of Medicine, Hangzhou, China.
FAU - Feng, Wei-Ying
AU  - Feng WY
AD  - Department of Hematology, Shaoxing People's Hospital, Wenzhou, China.
FAU - Zhao, Pu
AU  - Zhao P
AD  - Department of Hematology, Ruian People's Hospital, Wenzhou, China.
FAU - Jiang, Jin-Hong
AU  - Jiang JH
AD  - Department of Hematology, Lishui City People's Hospital, Lishui, China.
FAU - Hu, Bei-Li
AU  - Hu BL
AD  - Department of Hematology, The Second Affiliated Hospital of Jiaxing University, 
      Jiaxing, China.
FAU - Zhang, Jin
AU  - Zhang J
AD  - Department of Hematology, Sir Run Run Shaw Hospital (SRRSH) Affiliated with the 
      Zhejiang University School of Medicine, Hangzhou, China.
FAU - Qian, Su-Ying
AU  - Qian SY
AD  - Department of Hematology, Hwa Mei Hospital, University of Chinese Academy of 
      Sciences, Ningbo, China.
FAU - Wu, Gong-Qiang
AU  - Wu GQ
AD  - Department of Hematology, Dongyang Hospital Affiliated to Wenzhou Medical 
      University, Jinhua, China.
FAU - Wu, Wen-Ping
AU  - Wu WP
AD  - Department of Hematology, People's Hospital of Quzhou, Quzhou, China.
FAU - Qiu, Lei
AU  - Qiu L
AD  - Department of Hematology, Zhoushan Hospital, Zhoushan, China.
FAU - Li, Lin-Jie
AU  - Li LJ
AD  - Department of Hematology, Lishui Municipal Central Hospital, Jinhua, China.
FAU - Lang, Xiang-Hua
AU  - Lang XH
AD  - Department of Hematology, The First People's Hospital of Yongkang, Jinhua, China.
FAU - Chen, Sai
AU  - Chen S
AD  - Department of Hematology, Taizhou Central Hospital (Taizhou University Hospital), 
      Taizhou, China.
FAU - Chen, Li-Li
AU  - Chen LL
AD  - Department of Hematology and Oncology, Taizhou First People's Hospital (Huangyan 
      Hospital of Wenzhou Medical University), Taizhou, China.
FAU - Guo, Jun-Bin
AU  - Guo JB
AD  - Department of Hematology and Oncology, The First People's Hospital of Wenling, 
      Taizhou, China.
FAU - Cao, Li-Hong
AU  - Cao LH
AD  - Department of Hematology, Shulan Hospital, Hangzhou, China.
FAU - Jiang, Hui-Fang
AU  - Jiang HF
AD  - Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, China.
FAU - Xia, Yong-Ming
AU  - Xia YM
AD  - Department of Hematology, Rheumatology and Nephrology, Yuyao People's Hospital, 
      Ningbo University Yangming Affiliated Hospital, Ningbo, China.
FAU - Le, Jing
AU  - Le J
AD  - Department of Hematology and Oncology, Ningbo Medical Center Lihuili Hospital, 
      Ningbo, China.
FAU - Zhao, Jian-Zhi
AU  - Zhao JZ
AD  - Department of Hematology, Shaoxing Central Hospital, Shaoxing, China.
FAU - Huang, Jian
AU  - Huang J
AD  - Department of Hematology, The Fourth Affiliated Hospital Zhejiang University 
      School of Medicine, Jinhua, China.
FAU - Zhang, Yue-Feng
AU  - Zhang YF
AD  - Department of Hematology, The First People's Hospital of Yuhang District, 
      Hangzhou, China.
FAU - Lv, Ya-Li
AU  - Lv YL
AD  - Department of Hematology, Xinchang People's Hospital, Shaoxing, China.
FAU - Hua, Jing-Sheng
AU  - Hua JS
AD  - Department of Hematology and Oncology, Taizhou Municipal Hospital, Taizhou, 
      China.
FAU - Hong, Yong-Wei
AU  - Hong YW
AD  - Department of Hematology, Ningbo Yinzhou No. 2 Hospital, Ningbo, China.
FAU - Zheng, Cui-Ping
AU  - Zheng CP
AD  - Department of Hematotherapeutic, Wenzhou Central Hospital Medical Group, Wenzhou, 
      China.
FAU - Wang, Ju-Xiang
AU  - Wang JX
AD  - Department of Hematology and Oncology, The Second Affiliated Hospital and Yuying 
      Children's Hospital of Wenzhou Medical University, Wenzhou, China.
FAU - Hu, Bin-Fei
AU  - Hu BF
AD  - Department of Pediatric Hematology, Ningbo Women and Children's Hospital, Ningbo, 
      China.
FAU - Chen, Xiao-Hui
AU  - Chen XH
AD  - Department of Hematology, The Affiliated Hospital of Hangzhou Normal University, 
      Hangzhou, China.
FAU - Zhang, Li-Ming
AU  - Zhang LM
AD  - Department of Hematology, Zhuji People's Hospital, Shaoxing, China.
FAU - Tao, Shi
AU  - Tao S
AD  - Department of Hematology, Shaoxing Second Hospital, Shaoxing, China.
FAU - Xie, Bing-Shou
AU  - Xie BS
AD  - Department of Hematology, Wenzhou People's Hospital, Wenzhou, China.
FAU - Kuang, Yue-Min
AU  - Kuang YM
AD  - Department of Hematology, Jinhua People's Hospital, Jinhua, China.
FAU - Luo, Wen-Ji
AU  - Luo WJ
AD  - Department of Hematology, The First People's Hospital of Xiaoshan District, 
      Hangzhou, China.
FAU - Su, Ping
AU  - Su P
AD  - Department of Hematology, Zhejiang Xiaoshan Hospital, Hangzhou, China.
FAU - Guo, Jun
AU  - Guo J
AD  - Department of Hematology and Oncology, The Sencond Affiliated Hospital of 
      Zhejiang University, SAHZU Changxing Branch, Huzhou, China.
FAU - Wu, Xiao
AU  - Wu X
AD  - Department of Oncology and Hematology, The Affiliated Hospital of Medical School 
      of Ningbo University, Ningbo, China.
FAU - Jiang, Wei
AU  - Jiang W
AD  - Department of Hematology, Shangyu People's Hospital, Shaoxing, China.
FAU - Zhang, Hui-Qi
AU  - Zhang HQ
AD  - Department of Hematology, The First People's Hospital of Huzhou, Huzhou, China.
FAU - Zhang, Yun
AU  - Zhang Y
AD  - Department of Hematotherapeutic, Yueqing People's Hospital, Wenzhou, China.
FAU - Chen, Chun-Mei
AU  - Chen CM
AD  - Department of Hematotherapeutic, The Second Affiliated Hospital of Zhejiang 
      Chinese Medical University, Hangzhou, China.
FAU - Xu, Xiao-Feng
AU  - Xu XF
AD  - Department of Oncology and Hematology, Hangzhou Red Cross Hospital, Hangzhou, 
      China.
FAU - Guo, Yan
AU  - Guo Y
AD  - Department of Hematology, The First People's Hospital of Pinghu, Jiaxing, China.
FAU - Tu, Jin-Ming
AU  - Tu JM
AD  - Department of Gastroenterology and Hematology, Longyou People's Hospital, Quzhou, 
      China.
FAU - Hu, Shao
AU  - Hu S
AD  - Department of Hematology and Oncology, The First Hospital of Ninghai County, 
      Ningbo, China.
FAU - Yan, Xiao-Yan
AU  - Yan XY
AD  - Department of Biostatistics, Peking University Clinical Research Institute, 
      Beijing, China.
FAU - Yao, Chen
AU  - Yao C
AD  - Department of Biostatistics, Peking University Clinical Research Institute, 
      Beijing, China.
FAU - Lou, Yin-Jun
AU  - Lou YJ
AD  - Department of Hematology, The First Affiliated Hospital, College of Medicine, 
      Zhejiang University, Hangzhou, China.
FAU - Jin, Jie
AU  - Jin J
AD  - Department of Hematology, The First Affiliated Hospital, College of Medicine, 
      Zhejiang University, Hangzhou, China.
AD  - Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, 
      China.
AD  - Zhejiang University Cancer Center, Hangzhou, China.
AD  - Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical 
      Center, Hangzhou, China.
CN  - APL Cooperative Group of Zhejiang Province
LA  - eng
PT  - Journal Article
DEP - 20211116
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8637823
OTO - NOTNLM
OT  - ATRA
OT  - acute promyelocytic leukemia
OT  - arsenic
OT  - early death
OT  - survival
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/12/07 06:00
MHDA- 2021/12/07 06:01
PMCR- 2021/11/16
CRDT- 2021/12/06 09:19
PHST- 2021/08/22 00:00 [received]
PHST- 2021/10/21 00:00 [accepted]
PHST- 2021/12/06 09:19 [entrez]
PHST- 2021/12/07 06:00 [pubmed]
PHST- 2021/12/07 06:01 [medline]
PHST- 2021/11/16 00:00 [pmc-release]
AID - 10.3389/fonc.2021.762653 [doi]
PST - epublish
SO  - Front Oncol. 2021 Nov 16;11:762653. doi: 10.3389/fonc.2021.762653. eCollection 
      2021.